DERRICK JAMES DERKSEN (NPI# 1184182016) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184182016 |
| Entity Type | Individual |
| Full Name | DERRICK JAMES DERKSEN |
| Credential | BA CADC CANDIDATE |
| Practice Address |
5401 Sw 29th St Oklahoma City OK 73179-7602 |
| Mailing Address |
716 Royal Ave Midwest City OK 73130-2713 |
| Practice Telephone | 4056867828 |
| Practice Fax Number | 4056867827 |
| Mailing Telephone | 4056405220 |
| Mailing Fax Number | 4056867827 |
| Enumeration Date | 2019-03-11 |
| Last Update Date | 2019-03-11 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | OK | Other Service Providers |
| Street Address |
5401 SW 29TH ST |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73179-7602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295994663 | Vcphcs Iv, LLC | Counselor | 5401 Sw 29th St, Oklahoma City, OK 73179-7602 | 2008-06-02 |
| 1164856688 | Carolyn Jarrett | Licensed Practical Nurse | 5401 Sw 29th St, Oklahoma City, OK 73179-7602 | 2013-09-03 |
| 1235563719 | Gerald E Leischner | Counselor | 5401 Sw 29th St, Oklahoma City, OK 73179-7602 | 2013-09-03 |
| 1235563750 | Natalie Suzanne Nace | Counselor | 5401 Sw 29th St, Oklahoma City, OK 73179-7602 | 2013-09-03 |
| 1548694227 | Carol Hilton | Registered Nurse | 5401 Sw 29th St, Oklahoma City, OK 73179-7602 | 2013-08-29 |
| 1184058869 | Ericia Michell Oliver | Registered Nurse | 5401 Sw 29th St, Oklahoma City, OK 73179-7602 | 2013-08-29 |
| 1508159401 | Ronald Eric Latimer | Counselor | 5401 Sw 29th St, Oklahoma City, OK 73179-7602 | 2011-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679063929 | Jamie Guthrie | Nurse Practitioner | 4104 Windgate West, Okc, OK 73179 | 2018-05-12 |
| 1063486280 | Tanya M Keck-smith | Physician Assistant | 5031 Sw 29th Street, Access Medical Center, Oklahoma City, OK 73179 | 2006-02-14 |
| 1902285075 | Julie Bynum | Registered Nurse | 3212 Wexford Ave, Oklahoma City, OK 73179-1202 | 2015-05-22 |
| 1801145388 | Cheryl Lynn Dixon | Counselor | 3221 Wexford Ave, Oklahoma City, OK 73179-1203 | 2012-08-30 |
| 1528539541 | Sheena Margariet Musgrove | Nurse Practitioner | 3101 Hampshire Ln, Oklahoma City, OK 73179-1206 | 2018-12-17 |
| 1588828826 | Kelly S. Beals, Inc. | Dietitian, Registered | 3220 Rockhampton Ave, Oklahoma City, OK 73179-1223 | 2008-07-16 |
| 1104396548 | Adalis Alyse Parker | Student in an Organized Health Care Education/Training Program | 9512 Sw 31st St, Oklahoma City, OK 73179-1232 | 2018-11-28 |
| 1477967966 | Eloisa Perez | Counselor | 3216 Westbury Glen Blvd, Oklahoma City, OK 73179-1246 | 2014-06-12 |
| 1366799371 | Kasandra Deann Redwine | Behavioral Analyst | 3200 Westbury Glen Blvd, Oklahoma City, OK 73179-1246 | 2012-08-08 |
| 1063873966 | Lacey Elizabeth Krivanek | Speech-Language Pathologist | 3209 Westbury Glen Blvd, Oklahoma City, OK 73179-1247 | 2016-03-19 |
| Find all providers in zip 73179 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508467994 | Yenth Matilde Chaidez | Case Manager/Care Coordinator | 10409 Casa Linda, Oklahoma City, OK 73139-5510 | 2020-11-03 |
| 1760082523 | Alimot Shadia L Karim | Case Manager/Care Coordinator | 1330 N Classen Blvd Ste 314, Oklahoma City, OK 73106-6834 | 2020-10-29 |
| 1336749852 | Reshanna Leshae Childs-russell | Case Manager/Care Coordinator | 10505 Windway Ave, Oklahoma City, OK 73162-8001 | 2020-10-26 |
| 1770182065 | Ifeoluwa Ochuwa Idode | Case Manager/Care Coordinator | 8135 Bigwood Drive, Oklahoma City, OK 73135 | 2020-10-19 |
| 1689281180 | Michael Antem Abane | Case Manager/Care Coordinator | 11018 N May Ave Apt 218, Oklahoma City, OK 73120-6310 | 2020-09-28 |
| 1932715091 | Robyn Olukaikpe | Case Manager/Care Coordinator | 1736 Ne 14th St, Oklahoma City, OK 73117-3616 | 2020-09-23 |
| 1720694961 | Latasha Howell | Case Manager/Care Coordinator | 2416 Nw 12th St, Oklahoma City, OK 73107-5608 | 2020-09-22 |
| 1982218822 | Sybril Renee Jeffery | Case Manager/Care Coordinator | 8700 Sw 39th St, Oklahoma City, OK 73179-3878 | 2020-09-08 |
| 1871106096 | Harmonious Healing Counseling, LLC | Case Manager/Care Coordinator | 10802 Quail Plaza Dr Ste 205, Oklahoma City, OK 73120-3121 | 2020-08-27 |
| 1407466816 | Stephanie Denise Hollier | Case Manager/Care Coordinator | 1126 Nw 81st St, Oklahoma City, OK 73114-1811 | 2020-08-01 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73179 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.